The Androgen Insensitivity Syndrome Support Group of Australia congratulates Nature on its detailed and thought-provoking article “The most important sexual organ” (Nature 427, 390–392; 2004). Clinical management of children affected by intersex conditions is very difficult and controversial, largely because of the many ethical and legal considerations. (See for more information.)

Countries across the world, along with the United Nations, have long recognized the rights of children to physical integrity and have banned the practice of female genital mutilation. True, the operations performed on children with intersex conditions are set in a proper clinical environment and are intended to help them develop a gender identity. But the lasting effects of reducing potential for full enjoyment of sexual experiences are often ignored — along with a person's right to make informed decisions.

What about the 8% of children with intersex conditions who are raised in the wrong sex? Are these children's lives not worth the price of waiting to perform irreversible surgery?

The day will soon come when doctors will be sued for performing these non-therapeutic operations, and I will welcome that day. If common sense is not enough, it will take the risk of litigation to make some doctors rethink the treatment of children with intersex conditions.